Top 10 from ACG: Clostridioides difficile, CRC screening, health disparities
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Healio Gastroenterology presents the following report on the top 10 peer-tested stories from the ACG Annual Scientific Meeting 2021.
Stories include research in microbiome restoration for recurrent Clostridioides difficile, blood-based screening tests for colorectal cancer, health disparities in colon cancer and more.
Investigational therapeutic restores microbiome diversity in recurrent C. difficile
LAS VEGAS — CP101, an investigational microbiome therapeutic, restored microbiome diversity and prompted a sustained clinical cure among patients with recurrent Clostridioides difficile infection, according to a presentation.
“Recurrent C. difficile infection is common following standard of care antibiotics and remains a significant burden on the health care system. Treatment guidelines recommend standard of care antibiotics; however, these therapies lead to significant microbiome disruptions which impairs colonization resistance,” Jessica R. Allegretti, MD, MPH, FACG, an attending gastroenterologist and director of the fecal transplant program for recurrent C. difficile at Brigham and Women’s Hospital and instructor of medicine at Harvard Medical School in Boston, said during her presentation at the ACG Annual Scientific Meeting. “Therefore, we desperately need new therapeutics to enhance microbiome recovery, measured by the increase in microbiome diversity, and enhance colonization resistance.” Read more.
Blood-based CRC screening test identifies asymptomatic, low-grade tumors
LAS VEGAS — Multimodal circulating tumor DNA blood-based colorectal cancer screening tests may have clinically meaningful performance among patients in an average risk screening population, according to a presentation.
“Blood-based colorectal cancer screening holds potential to improve compliance with CRC screening recommendations given the ability to seamlessly integrate a blood-based test into standard of care clinical pathways,” Hee Cheol Kim, MD, of the Samsung Medical Center and Sungkyunkwan University School of Medicine in Seoul, South Korea, said during the ACG Annual Scientific Meeting presentation. “However, to contribute significantly to the CRC screening landscape, the blood-based screening test must detect CRC across multiple clinical parameters in order to prove clinically meaningful.” Read more.
Practical steps can move needle on health disparities in colon cancer screening
LAS VEGAS – Prioritizing equity efforts and taking three key steps toward improving accessibility and representation could move the needle on health disparities in colon cancer screening, according to an ACG Postgraduate Course presentation.
“We have had over 3 decades of evidence that suggest that colorectal cancer screening saves lives. We are doing screening as a means to prevent, interrupt or delay development of advanced disease because we know if we detect it early, the survival rate is quite high,” Darrell M. Gray II, MD, MPH, FACG, chief health equity officer for Anthem Inc., said during his postgraduate course presentation prior to ACG 2021. “Unfortunately, colorectal cancer and the burden of disease are not evenly distributed.” Read more.
Stool tests provide speedy results for predicting H. pylori antibiotic resistance
LAS VEGAS – Using next generation sequencing through stool samples to predict Helicobacter pylori antibiotic resistance offered rapid results equivalent to those from gastric biopsies, according to a presentation at the ACG Annual Scientific Meeting.
“The bottom line is that the availability of the stool-based test will make it much easier to choose an H. pylori eradication regimen in difficult cases, such as after failure of a first line therapy,” Steven Moss, MD, a clinical gastroenterologist at Rhode Island Hospital and director of the Brown University Gastroenterology Fellowship Training Program, both in Providence, Rhode Island, told Healio Gastroenterology. “The choice can now be based on scientific principles rather than guesswork.” Read more.
And Your 2021 Healio Disruptive Innovators Are...
During the ACG Annual Meeting, the 2021 Healio Disruptive Innovators were honored. This was the Fourth Healio Disruptive Innovators Awards ceremony.
Each of the awardees in the eight categories has changed the face of gastroenterology and pushed the status quo toward the betterment of the field. Read more.
VIDEO: Patient advocate sheds light on ‘urgency’ to treat chronic liver disease
LAS VEGAS – In this video exclusive, Donna Cryer, JD, founder, president and CEO of Global Liver Institute, spoke on the launch of the Liver Health Annual Trends Report and its possible impact for patients with chronic liver disease.
Cryer, a 27-year liver transplant recipient and former chronic liver disease patient, said this is the first report offering robust data on chronic liver disease that may fuel program development and patient advocacy. Read more.
Resiliency, respect, relationships: A ‘laser-focused’ mission for ACG
LAS VEGAS – Resiliency, respect and relationships allowed the ACG to thrive during the pandemic, pushed the careers of its leaders forward and brought the association back to in-person meetings.
“It has been a remarkable year. ... I also saw a focus for the year that would clearly be defined by COVID-19 and those three R words: resiliency, respect and relationships,” David A. Greenwald, MD, FACG, outgoing ACG president, said during his President’s Address at the ACG Annual Scientific Meeting. “To keep laser focused on that mission, I posted those three words on a sticky note on my computer monitor.” Read more.
Treating alcohol use disorder may reduce alcohol-associated liver disease mortality
LAS VEGAS – Pharmacological treatments of alcohol use disorder have been found to improve mortality outcomes for patients with alcohol-associated liver disease, according to a presenter at the ACG Annual Scientific Meeting.
“Our study found that these medications are underutilized. It is associated with 1-year lower mortality in patients admitted with alcohol-associated liver disease, and we do need further studies to try and increase the utilization of these medications,” Patrick Twohig, MD, MPH, a second-year gastroenterology and hepatology fellow at the University of Nebraska Medical Center, said during his presentation. Read more.
‘No compelling evidence’ for fecal occult blood testing prior to cardiac catheterization
LAS VEGAS — Patients with acute coronary syndrome had similar outcomes for all-cause mortality and bleeding events regardless of undergoing fecal occult blood tests, according to a presentation at the ACG Annual Scientific Meeting.
“Fecal occult blood testing is not recommended in the in-patient setting,” Lauren Searls, DO, of the Charleston Area Medical Center and West Virginia University School of Medicine, said during the presentation. “However, we note that it’s often ordered to assess for gastrointestinal blood loss. In the in-patient setting, FOBT increases GI consults, increases the rate of endoscopic intervention and has a high type 1 error reported in the literature at up to 50%.” Read more.
Squatting improves rectal evacuation among younger women with defecatory dysfunction
LAS VEGAS – Squatting assist stools improved rectal evacuation in defecatory dysfunction among women who were younger with normal stool consistency and lower resting anal sphincter pressure, according to research presented at ACG.
“The squatting assist stool (SAS) has become popularized in the last decade. In theory it works by straightening the anorectal angle to improve mechanics of evacuation,” Lauren Ulsh, MD, a second-year resident at Stanford University Medical Center, said. “We hypothesized that squatting can help some individuals with defecatory dysfunction overcome anorectal dyssynergia.” Read more.
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